Study Questions:

What are the knowledge, beliefs, social norms, and behaviors regarding use of alternative tobacco products among undergraduate and graduate nursing students in a large, urban university?

Methods:

All undergraduate and graduate nursing students were surveyed about their knowledge, beliefs, social norms, and behaviors regarding alternative tobacco products. A similar survey had been distributed to medical students at the same institution.

Results:

The participants had limited knowledge of the health risks that alternative tobacco products potentially pose to cardiovascular health. Participants had a greater understanding of the risk of cardiovascular disease from smoking cigarettes compared with alternative tobacco products (0.92 vs. 0.68; p < .001). The participants had a limited knowledge of the amount of harmful products that was present in e-cigarettes (8%). The participants reported that the rate of friends (67.1%) and family (34.1%) using tobacco products was higher than the national average (34%). The younger the student, the more likely it was that he or she had friends who used tobacco products (39.7% vs. 27.4%; p < 0.001). The students’ rate of using tobacco products was at 7.9%, which is similar to the national average for healthcare providers.

Conclusions:

Nursing and medical students have limited knowledge about the health risks of alternative tobacco products compared with cigarettes. Even though the use of cigarettes was lower among the students than their family and friends, tobacco use, including alternative tobacco products, was still considered a social norm.

Perspective:

There has been an overall reduction in cigarette smoking in the United States, but the use of alternative tobacco products is increasing and becoming socially acceptable. Because of this, there remains the threat of an increase in the incidence of cardiovascular disease. It is critical that health professionals conduct research and educate themselves about the risks of alternative tobacco products in order to impact excessive tobacco-related mortality.